Home Office

British Nationality: Ceremonies

Patrick Grady: To ask the Secretary of State for the Home Department, when citizenship ceremonies will resume across the UK as covid-19 lockdown restrictions are eased.

Kevin Foster: It is for each Local Authority to determine when they will be able to resume Citizenship Ceremonies in line with current government advice relating to social distancing and public safety.A small trial of remote ‘virtual ceremonies’ has recently taken place successfully and further work is now being done to make these more widely available.

Visas: Health Professions

Nadia Whittome: To ask the Secretary of State for the Home Department, when she plans to publish further details on the Health and Care Visa.

Kevin Foster: The Government laid the “Immigration and Nationality (Fees) (Amendment) (No.3) Regulations 2020”, in Parliament on 14 July.We also published updated Tier 2 policy guidance, which includes information on the Health and Care Visa. The updated guidance is available at:https://www.gov.uk/government/publications/guidance-on-application-for-uk-visa-as-tier-2-worker.The Health and Care Visa will open for applications on 4 August.

Department of Health and Social Care

Coronavirus: Hospitals

Dr Ben Spencer: To ask the Secretary of State for Health and Social Care, what proportion of the capacity at NHS Nightingale Hospitals are being used; and what plans are in place for the use of the remainder of the capacity if it is not required at this stage of the covid-19 outbreak.

Edward Argar: Bed availability and occupancy rates are collected and published via the national reporting system at the following link: https://www.england.nhs.uk/statistics/statistical-work-areas/bed-availability-and-occupancy/ However, information is only published at trust level. The Nightingale hospitals in London (Barts Health NHS Trust) and the North West (Manchester University NHS Foundation Trust) are the only two to have accepted COVID-19 patients at this time. All Nightingale hospitals are now on standby.

Coronavirus: Death

Clive Lewis: To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the correlation between the UK accounting for (a) 10 per cent of global covid-19 deaths and (b) 1 per cent of the global population.

Jo Churchill: It is difficult to compare COVID-19 deaths numbers for different countries as different countries measure deaths in different ways, reporting on very different health and care systems.A full assessment of international comparisons may not be possible until much later in the epidemic, but we will draw on the full range of international experience to learn the lessons from our response to this virus.

Eyesight: Health Services

Marion Fellows: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that communications on the importance of attending eyecare appointments for sight saving treatment is part of the NHS Open for Business communications campaign.

Jo Churchill: Holding answer received on 02 June 2020



The ‘Help Us Help You’ campaign has been developed by NHS England and NHS Improvement to encourage people to continue to access NHS services when they need healthcare during the pandemic.Campaign assets have been made available for regional and local National Health Service communications teams to use, as well as partner organisations, such as charities. Further campaign materials have been targeted to a range of priority services and conditions, which have experienced a significant decrease in people accessing them or presenting with symptoms, such as cancer and stroke, and maternity and mental health services.In line with NHS England and NHS Improvement guidance issued to National Health Service trusts on 17 March, all clinically urgent care should have continued to be available throughout the height of the pandemic. Urgent care would include urgent sight saving treatment.A copy of the letter to NHS trusts is available at the following link:https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/20200317-NHS-COVID-letter-FINAL.pdf

Coronavirus: Ethnic Groups

Dr Philippa Whitford: To ask the Secretary of State for Health and Social Care, what representations he has received on the alleged omission of recommendations that could help protect BAME people from covid-19 from the Government's review of disparities in risks and outcomes.

Jo Churchill: Various representations were received on the alleged omission of recommendations from Public Health England’s report entitled ‘COVID-19: review of disparities in risks and outcomes’, published on 2 June 2020. No recommendations were removed.Alongside the epidemiological review, Professor Fenton undertook a rapid evidence review and external stakeholder engagement with a significant number of individuals and organisations within the black, Asian and minority ethnic community, to hear their views, concerns and ideas about the impact of COVID-19 on their communities. The results of that work have now been published and will inform the Government’s next steps being taken forward by the Parliamentary Under-Secretary of State for Equalities (Kemi Badenoch MP).

Health Professions

Daisy Cooper: To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of (a) health visitors, (b) sure start centres and (c) family nurse partners in each year from 2014-15 to 2019-20.

Jo Churchill: Responsibility for commissioning of health visiting services transferred to local authorities in October 2015. Local authorities are best placed to respond to the needs of their local population.National Health Service trusts and private sector organisations to provide health visiting services. There is no single source that counts health visitors across the whole public sector.NHS Digital publishes Hospital and Community Health Services workforce statistics. These include staff working in hospital trusts and clinical commissioning groups, but not staff working in primary care, general practitioner surgeries, local authorities or other providers. Health visitors full time equivalent (FTE)September 201510,236September 20169,521September 20178,497September 20187,884September 20197,063March 20206,828 Source: NHS Digital. NHS Workforce Statistics NHS Digital collects and publishes data on staff, including health visitors, in some English independent sector healthcare organisations. These statistics do not represent the entire independent sector workforce as only 59 organisations provided data for March 2020.The following table shows the number of FTE health visitors as at September each year since 2015 and March 2020, which is the latest available data.  Health visitors FTESeptember 2015957September 20161,132September 20171,240September 20181,085September 20191,147 Source: NHS Digital. Independent Healthcare Provider Workforce Statistics As at March 2020, there were 3,022 children’s centre sites open to families and children providing children’s centre services. Information is not held centrally on the number of family nurse partners.

Vaccination: Children

Catherine West: To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the effect  of the covid-19 outbreak on the delivery of routine child vaccination programmes.

Jo Churchill: Public Health England (PHE) has published a study on the early impact of COVID-19 on routine childhood vaccinations in England, which suggests that there has not been a significant impact on the number of primary immunisation doses administered compared to the previous year. Whilst there is some indication of a decrease in the first dose of the Measles, Mumps and Rubella vaccination, this appears to be recovering. Further information is available at the following link:https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.19.2000848 School immunisation programmes were paused as a result of school closures and PHE and NHS England and NHS Improvement are now working with regional commissioners to restore school-age vaccination programmes as quickly as possible.

Vaccination: Children

Catherine West: To ask the Secretary of State for Health and Social Care, what steps he is taking to (a) ensure vulnerable children receive routine vaccinations during the covid-19 outbreak and (b) provide a catch-up programme for vulnerable children who may have missed their vaccinations.

Jo Churchill: The Government’s Coronavirus Action Plan stated that everyone should ensure that they and their family’s vaccinations were up-to-date. The Action Plan is available at the following link:https://www.gov.uk/government/publications/coronavirus-action-plan/coronavirus-action-plan-a-guide-to-what-you-can-expect-across-the-ukPublic Health England and NHS England and NHS Improvement have worked with regional commissioners to ensure routine childhood immunisations continued to be delivered in primary care settings during the COVID-19 outbreak. Programmes delivered through schools were paused as a result of school closures, but plans are in operation for their recovery, for example by vaccinating during the school holidays, to ensure that all children who missed a routine immunisation are caught up as quickly as possible.

Coronavirus: Children

Seema Malhotra: To ask the Secretary of State for Health and Social Care, what his Department's policy is on home visiting community phlebotomy for children with serious health conditions which require them to be shielding during the covid-19 outbreak.

Jo Churchill: Holding answer received on 06 July 2020



When shielding, adults and children should continue to receive the healthcare and support they need at home wherever possible, preferably virtually or online. Where remote service delivery is not possible, for example in the case of phlebotomy, this should be delivered through infection-controlled home visiting where clinically necessary. In guidance issued on 4 June, systems were therefore instructed to expand and resource all relevant home-based services such as a home-visiting phlebotomy service. The guidance is available at the following link:https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0583-nhs-update-on-shielding-june-2020.pdf

Emergencies: Planning

Helen Hayes: To ask the Secretary of State for Health and Social Care, how much Public Health England has spent on civil contingencies preparedness in each year since 2010.

Jo Churchill: Holding answer received on 07 July 2020



The data is not held in the format requested.

Vaccination: Older People

Stephen Hammond: To ask the Secretary of State for Health and Social Care, what estimate his Department has made of the number of older people who have missed a routine vaccination as a result of shielding during the covid-19 outbreak.

Jo Churchill: Shingles and pneumococcal polysaccharide vaccine (PPV23) are the main two routine vaccinations that are likely to have been missed by older people as a result of shielding during COVID-19. General practices are responsible for identifying those patients who have missed vaccination appointments and are working with NHS England and NHS Improvement to ensure that any individual who has missed a routine appointment is caught up as quickly as possible, whilst maintaining effective protection for those who continue to be at higher risk of COVID-19.

Cancer: Health Services

Charlotte Nichols: To ask the Secretary of State for Health and Social Care, what plans he has to increase cancer (a) screening and (b) treatment.

Jo Churchill: The Government committed in the NHS Long Term Plan to detect 75% of cancers at stage 1 or 2, and for 55,000 more people to survive cancer for five years in England each year from 2028.We have established a comprehensive Screening Improvement Programme that includes actions we need to take to improve our national screening programmes and save even more lives through the early detection of cancer. We are also trialling the expansion of the Breast Screening Programme, offering additional screening to 47-49 and 71-73 year old women through the AgeX trial.We are increasing cancer treatment through investing in Cancer Alliances across England to ensure each cancer patient gets the right care for them. This includes the establishment of Rapid Diagnostic Centres - for the first time there will be a route of referral for patients with non-specific symptoms that could indicate cancer.

Ophthalmic Services

Bambos Charalambous: To ask the Secretary of State for Health and Social Care, what plans his Department has to begin collecting data on the effect of cancelled ophthalmology services on patients.

Bambos Charalambous: To ask the Secretary of State for Health and Social Care, if his Department will make an estimate of the number of people that will experience preventable sight loss as a result of (a) cancelled and (b) delayed services in 2020;  and how many ophthalmology patients who are shielding are unable to accesses time sensitive ophthalmology services.

Jo Churchill: Data is reported centrally on the number of cancelled or delayed outpatient ophthalmology appointments only. Guidance has been issued to local National Health Service providers and commissioners trusts on the restart of non-COVID-19 services, starting with the most clinically urgent cases and ensuring this is done safely with appropriate infection control. Local providers and their clinical teams, rather than the Department, are best placed to consider the appropriate management of patient cases locally as services are restarted.The Government is providing an additional £3 billion to the NHS, which includes funding for continued access to the independent sector to carry out routine treatments and procedures as well as provide additional capacity for COVID-19 patients, should it be needed.

Ophthalmic Services

Bambos Charalambous: To ask the Secretary of State for Health and Social Care, what steps his Department plans to take to reduce the number of patients who miss their follow up ophthalmology appointments.

Jo Churchill: The Government is actively planning and preparing for the potential impact of COVID-19 infections during winter 2020-21. National COVID-19 planning is in part informed on a reasonable worst case scenario, reflecting current scientific advice.As the evidence base and scientific understanding evolves, the Government seeks to update planning assumptions, informed by advice and modelling from Scientific Advisory Group for Emergencies (SAGE) and its subgroups. In recognition of the importance of transparency in these unprecedented times, SAGE has been publishing minutes and papers on the Government website.To prepare the National Health Service for winter, the Government is providing an additional £3 billion of funding to the NHS. This includes funding to allow the NHS to maintain the Nightingale surge capacity and continue to use the extra hospital capacity available within the independent sector.

Swine Flu

Jon Trickett: To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the level of risk to the UK of the G4 EA H1N1 virus.

Jo Churchill: We continually assess the most significant threats that the United Kingdom and its citizens could face, including natural hazard risks such as a pandemic influenza. In line with our standard practice, Public Health England is undertaking a risk assessment of the G4 influenza virus and we will take any appropriate action based on robust scientific and clinical advice.

Blood Cancer: Coronavirus

Liz Saville Roberts: To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the risk covid-19 poses to people with blood cancer.

Jo Churchill: Holding answer received on 20 July 2020



NHS England and NHS Improvement produced a list at the beginning of the pandemic of those who were at higher risk of becoming seriously ill if they contracted COVID-19. This list has two levels of higher risk:- High risk (clinically extremely vulnerable); and- Moderate risk (clinically vulnerable).People who were high risk included those who have blood or bone marrow cancer, such as leukaemia, lymphoma or myeloma.It is advised that those with blood cancers follow the NHS England and NHS Improvement advice that is regularly updated on their website. This can be found at the following link:https://www.nhs.uk/conditions/coronavirus-covid-19/

Blood Cancer: Coronavirus

Layla Moran: To ask the Secretary of State for Health and Social Care, how many people with blood cancer are (a) shielding and (b) of working age.

Jo Churchill: Holding answer received on 20 July 2020



As of 16 July, NHS Digital data shows that 156,743 haematological cancer patients are currently shielding due to the COVID-19 pandemic.NHS Digital does not report the haematological cancers numbers by age group.

Breast Cancer: Screening

Jim Shannon: To ask the Secretary of State for Health and Social Care, what steps he is taking to address the number of screenings for breast cancer delayed following the covid-19 outbreak.

Jo Churchill: Where screening appointments have been delayed due to COVID-19, NHS England and NHS Improvement are working with breast cancer screening providers to ensure services are restored as soon and as safely as possible.NHS England and NHS Improvement are also working with Public Health England to prioritise appointments for those individuals who are most at risk of breast cancer and ways to make best use of the capacity available. This includes working on a tool that will enable local providers to model capacity against demand for breast screening and identify where targeted actions are needed to increase access to appointments.Funding has also been made available to local teams to adapt mobile breast screening units so that appointments can go ahead safely.

Cervical Cancer: Screening

Jim Shannon: To ask the Secretary of State for Health and Social Care, what steps he is taking to address the number of cervical smear tests delayed following the covid-19 outbreak.

Jo Churchill: NHS England and NHS Improvement are aware that in some areas, providers of NHS Cervical Screening Programme services have, for operational reasons and to minimise risk to patients during the coronavirus pandemic, rescheduled invitations or appointments to a later date. NHS England and NHS Improvement are working with service providers to reschedule screening invitations as soon as possible, whilst ensuring this is managed safely for patients and staff.General practitioners are reviewing their records to identify individuals who were unable to have a cervical screening appointment during the response to the pandemic and are now inviting those individuals to attend.

Pancreatic Cancer: Screening

Jim Shannon: To ask the Secretary of State for Health and Social Care, what steps he has taken to address the numbers of screening tests for pancreatic cancer wrequired following the covid-19 outbreak.

Jo Churchill: The diagnosis of pancreatic cancer is being aided by the roll out of Rapid Diagnostic Centres across the England to bring together the latest diagnostic equipment and expertise. This programme builds on the Multidisciplinary Diagnostic Centre model piloted through the Accelerate, Coordinate and Evaluate programme, which focussed on diagnosing cancers where patients often present with non-specific symptoms and may go to their general practitioner (GP) many times before being sent for appropriate tests, such as pancreatic cancer.Individuals are encouraged to contact their GP if they are concerned about any unusual symptoms.

Members: Correspondence

Mr John Baron: To ask the Secretary of State for Health and Social Care, when he plans to respond to the correspondence of 27 April, 15 May, and 18 June 2020 from the hon. Member for Basildon and Billericay regarding constituent Councillor Schrader.

Jo Churchill: Holding answer received on 21 July 2020



My noble Friend, the Parliamentary Under-Secretary of State for Innovation (Lord Bethell), replied to the hon. Member’s letter on 17 July 2020.

Coronavirus: Disease Control

Chi Onwurah: To ask the Secretary of State for Health and Social Care, what (a) forecasts and (b) modelling the Government has conducted on the potential effect of a second wave of covid-19 infections this winter; and what steps he has put in place to manage potential increased demand on the NHS.

Edward Argar: The Government is actively planning and preparing for the potential impact of COVID-19 infections during winter 2020-21. National COVID-19 planning is in part informed on a reasonable worst case scenario, reflecting current scientific advice.As the evidence base and scientific understanding evolves, the Government seeks to update planning assumptions, informed by advice and modelling from Scientific Advisory Group for Emergencies (SAGE) and its subgroups. In recognition of the importance of transparency in these unprecedented times, SAGE has been publishing minutes and papers on the Government website.To prepare the National Health Service for winter, the Government is providing an additional £3 billion of funding to the NHS. This includes funding to allow the NHS to maintain the Nightingale surge capacity and continue to use the extra hospital capacity available within the independent sector.

Children and Young People: Coronavirus

Tulip Siddiq: To ask the Secretary of State for Health and Social Care, what steps his Department is taking to develop a cross-departmental recovery plan for children, young people and families affected physically, mentally and emotionally by the covid-19 outbreak.

Jo Churchill: Holding answer received on 22 July 2020



The Department of Health and Social Care is working closely with the Department for Education in response to COVID-19. Guidance on restoration of community health services for children and young people has been published and can be found at the following link:https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0552-Restoration-of-Community-Health-Services-Guidance-CYP-version-3-June-2020-1.pdfWe are also supporting schools and colleges to provide a supportive environment for those experiencing problems and securing access to specialist help for those who need it.

Ovarian Cancer

Sarah Olney: To ask the Secretary of State for Health and Social Care, what steps he is taking to increase public awareness of the symptoms of ovarian cancer.

Jo Churchill: Holding answer received on 22 July 2020



Public Health England (PHE) has run several Be Clear on Cancer (BCOC) campaigns to help improve early detection of cancer. In 2014 PHE ran a regional ovarian cancer campaign and, in 2017, a pilot which focussed on a range of abdominal symptoms, such as diarrhoea, bloating and discomfort that can be indicative of several cancers, including ovarian cancer. PHE has undertaken data analysis and new research to determine the future direction of BCOC campaign activity and will also take into consideration the outcomes of these campaigns. Further information on the BCOC campaigns can be viewed at the following link: http://www.ncin.org.uk/cancer_type_and_topic_specific_work/topic_specific_work/be_clear_on_cancer/ Decisions on which cancers BCOC campaigns should focus on are informed by a steering group with representatives from PHE, the Department, NHS England and NHS Improvement, primary and secondary care clinicians, and key voluntary sector organisations. These decisions are under constant review, informed by the available data and medical information resources.

Rare Diseases: Coronavirus

Jim Shannon: To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effect of covid-19 on people with rare diseases; what steps he has taken to ensure access to NHS services by those people; and what assessment he has made of the effect of shielding on the health of those people.

Jo Churchill: The Department, alongside NHS England, is considering the impact of COVID-19 on patients with rare diseases. NHS England has had discussions with some services and patients/patient groups to understand the impact of COVID-19 including what has worked well; what has not worked so well; and opportunities for transformation.NHS England will continue to look at what services can be delivered successfully through virtual communication technology such as telephone consultation and videoconferences. Where services do need to be delivered face-to-face, NHS England will work with providers to ensure that patients have a safe journey through the hospital to the treatment area.It is not possible to reliably estimate what health outcomes and mortality rates would have been if shielding had not been implemented. Therefore, we cannot make an assessment of the effect of shielding on rare disease patients. NHS Digital published 'Tracking Healthcare Activity and Outcomes for Shielded Patients, England' on 21 July 2020:https://digital.nhs.uk/data-and-information/publications/statistical/mi-tracking-healthcare-activity-and-outcomes-for-shielded-patients-england/latest/contentThis is not an evaluation so conclusions on the shielding programme cannot be made from it.

Rare Diseases

Jim Shannon: To ask the Secretary of State for Health and Social Care, if he will make an assessment of the effect of covid-19 on the feasibility of delivering the UK Strategy for Rare Diseases; and whether he has plans to undertake a review of that strategy as a result of the covid-19 pandemic.

Jo Churchill: The Government is committed to improving the lives of those affected by rare disease and continues to implement the commitments made in the UK Strategy for Rare Diseases. The Department published its most recent update to the implementation plan for achieving the commitments in the Strategy in England in February 2020, which can be found at the following link:https://www.gov.uk/government/publications/uk-strategy-for-rare-diseases-2020-update-to-the-implementation-plan-for-englandIn October 2019, the national conversation on rare diseases survey was launched to identify the major challenges faced by those living and working with rare diseases. We received almost 6,300 responses which, alongside the lessons learned from the experiences of rare disease patients during the COVID-19 pandemic, will be used to shape the post-2020 UK Rare Diseases Framework which will replace the Strategy.

Obesity: Eating Disorders

Wera Hobhouse: To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 17 July 2020 to Question 66169 on obesity, what steps the Government is taking to ensure its work on tackling obesity does not cause harm to people with eating disorders.

Jo Churchill: We recognise concerns people with eating disorders may have on measures to reduce obesity and are committed to striking a careful balance between enabling people to make healthier food and drink choices whilst not negatively impacting on those with or recovering from an eating disorder. Obesity represents a huge cost to the health and wellbeing of the individual, the National Health Service and the wider economy. With over six in 10 adults and more than one in three children aged 10 to 11 years old overweight or obese, it is right we take action.

Cancer: Health Services

Rosie Cooper: To ask the Secretary of State for Health and Social Care, how many people with cancer have been offered a holistic needs assessment (HNA); and what steps he has taken to ensure that patients' needs are met as a result of an HNA.

Jo Churchill: I refer the hon. Member to the answer I gave on 1 July 2020 to Question 55913.